Bile Duct Cancer

Bile duct cancer — also called cholangiocarcinoma — is a rare and aggressive type of cancer that forms in the bile ducts. These ducts are thin tubes that carry bile (a digestive fluid) from the liver and gallbladder to the small intestine.

Types

There are three main types, based on where the cancer forms:

Intrahepatic cholangiocarcinoma

Inside the liver

Perihilar cholangiocarcinoma

At the junction where the left and right bile ducts exit the liver (also called Klatskin tumors)

Distal cholangiocarcinoma

Farther down near the small intestine

Risk Factors

Primary sclerosing cholangitis

(PSC)

Chronic liver disease

Like cirrhosis, hepatitis B or C

Bile duct stones

Certain liver fluke infections

Common in parts of Asia

Age

More common in people over 50

Symptoms

Gallbladder cancer often doesn’t cause symptoms in its early stages. When symptoms do appear, they may include:

Jaundice

Yellowing of the skin and eyes

Itchy skin

Dark urine, pale stools

Abdominal pain

Weight loss

Fever

Diagnosis

If gallbladder cancer is suspected, your doctor may perform several tests, including:

Imaging tests

Ultrasound, CT scan or MRI

Blood tests

To check for tumor markers like CA19-9 and CEA

Biopsy

A biopsy to confirm the diagnosis should NOT be required in most cases. DO NOT BIOPSY A SUSPECTED GALLBLADDER CANCER till you have been seen by a specialist surgeon!

Treatment Options

Surgery

Best chance for a cure if the cancer is localized

Liver transplant

In some very specific cases

Chemotherapy and/or radiation

If surgery isn’t possible or after surgery

Targeted therapy and immunotherapy

For advanced cases, especially if certain genetic mutations are found

Unfortunately, bile duct cancer is often diagnosed at a late stage, making it harder to treat. Research is ongoing to find better treatments.

Bile Duct Stone

Choledocholithiasis  which basically means a gallstone that’s made its way into the bile duct.

Bile duct stones can either form inside the bile ducts (called primary stones) or, more commonly, come from the gallbladder (secondary stones).

They block the normal flow of bile, causing issues like:

Pain

Especially right upper abdomen or mid-epigastric

Jaundice

Yellowing of the skin and eyes

Dark urine, pale stools

Fever and chills

If infection develops — called cholangitis, which can be life-threatening

Pancreatitis

If the stone blocks the pancreatic duct too

Diagnosis

Imaging

Ultrasound, MRCP (MRI scan of the bile ducts), ERCP (an endoscopy that can also treat the stones), Sometimes CT scans

Blood tests

Looking for liver function abnormalities

Treatment Options

ERCP to remove the stone

Endoscopic procedure through the mouth

Sometimes surgery if endoscopy fails or isn’t available
Antibiotics if there's an infection
Gallbladder removal (cholecystectomy)

Gallbladder removal (cholecystectomy) if the stones originated from there